NCT02325908|Terminated
Body Fluid Dynamics in Hemodialysis Patients, an Estimation of Dry Weight
Evaluation of Body Hydration Status in Hemodialysis Patients Using Segmental Bioimpedance Analysis
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Evaluation of Body Hydration Status in Hemodialysis Patients Using Segmental Bioimpedance Analysis
Sponsor study identifier
observational
89
0 countries
N/A
Study Start
April 2008
Date type not reportedThis date has not been verified as actual or estimated.
Primary Completion
December 2014
Actual (reported)Study Completion
February 2015
Actual (reported)The purpose of this study is to learn how the amount of fluid in the body of a hemodialysis patient affects him or her. Body hydration is the amount of fluid in the human body and known to be related to blood pressure. Too much fluid can lead to high blood pressure which can cause heart problems and eventually lead to death. Bioimpedance Spectroscopy (BIS) is a method that may be used to measure body hydration. This can be applied in the whole body, arm, trunk, calf, and leg. It is a non-invasive and inexpensive method and no known risk. BIS measurements can be used to assess optimal hydration status which is defined as a patient's ideal weight after completing a dialysis treatment. The investigators hypothesize that your target weight may be better estimated by the BIS. The results of this study, in particular the continuous measurement of calf hydration which is associated with the hydration of the whole body, may provide useful information about physiologic ("healthy") body hydration. It may possibly help to improve treatment procedures for patients in the future. The Renal Research Institute plans to enroll 100 chronic hemodialysis patients and 200 healthy controls in this study.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
February 2015
Actual (reported)Click on a node to explore related trials.
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
April 2008
Date type not reportedThis date has not been verified as actual or estimated.
December 2014
Actual (reported)December 16, 2014
Actual (reported)December 25, 2014
Actual (reported)February 2015
Actual (reported)Dry weight as determined by segmental bioimpedance in comparison to baseline
1 month
Mean pre dialysis and post dialysis blood pressure in comparison to baseline
1 month
Numbers and doses of blood pressure medications prescribed
1 month
Dialysis patients will have their estimated dry weight measured with calf segmental bioimpedance. Based on these measurements, their dry weight will be adjusted and the amount of fluid removed during subsequent dialysis treatments will be increased by 200-300mL. The additional fluid removal will occur during 3 consecutive hemodialysis sessions. In addition, these subjects will also use VStim during these treatments. to prevent common intradialytic symptoms by promoting vascular refilling.
No Intervention was administered. Both groups had their hydration status measured with segmental bioimpedance The group of healthy subjects was studied in order to obtain a range of values for normal hydration status.
Stable hemodialysis patients believed to be at all levels of hydration by their treating physician will be chosen. 100 subjects will be chosen to include approximately 50% women in the hemodialysis program. Subjects will be selected from a wide range of ages and body mass indexes
Spiegel DM, Bashir K, Fisch B. Bioimpedance resistance ratios for the evaluation of dry weight in hemodialysis. Clin Nephrol. 2000 Feb;53(2):108-14.
Jaeger JQ, Mehta RL. Assessment of dry weight in hemodialysis: an overview. J Am Soc Nephrol. 1999 Feb;10(2):392-403. doi: 10.1681/ASN.V102392.
Leypoldt JK, Cheung AK. Evaluating volume status in hemodialysis patients. Adv Ren Replace Ther. 1998 Jan;5(1):64-74. doi: 10.1016/s1073-4449(98)70016-0.
During every study day, 1 tube (3.5mL) will be collected before and 1 tube (3.5mL) after HD. This will be done at each study day until the subject reaches optimal hydration status. These samples will be used to assess Na+, K+, Ca++ concentrations and conductivity of the blood. We'll also measure aldosterone monthly.In case of technical issues (which may include device malfunction, transportation of samples, or scheduling of personnel), samples may be frozen temporarily. Samples may also be frozen and kept for future biochemical studies (see "Consent form for future biochemical studies").
Fansan Zhu, MD
Renal Research Institute
89 participants (actual enrollment reported by the registry).
First Submitted
December 16, 2014
First Posted
December 25, 2014
Study Start
April 2008
Date type not reportedThis date has not been verified as actual or estimated.
Serotonin Norepinephrine Reuptake Inhibitors and the Risk of Serious Adverse Events
Contact the study team to confirm eligibility.
Zhu F, Schneditz D, Wang E, Martin K, Morris AT, Levin NW. Validation of changes in extracellular volume measured during hemodialysis using a segmental bioimpedance technique. ASAIO J. 1998 Sep-Oct;44(5):M541-5. doi: 10.1097/00002480-199809000-00045.
Piccoli A. Identification of operational clues to dry weight prescription in hemodialysis using bioimpedance vector analysis. The Italian Hemodialysis-Bioelectrical Impedance Analysis (HD-BIA) Study Group. Kidney Int. 1998 Apr;53(4):1036-43. doi: 10.1111/j.1523-1755.1998.00843.x.
Katzarski K, Charra B, Laurent G, Lopot F, Divino-Filho JC, Nisell J, Bergstrom J. Multifrequency bioimpedance in assessment of dry weight in haemodialysis. Nephrol Dial Transplant. 1996;11 Suppl 2:20-3. doi: 10.1093/ndt/11.supp2.20.
Zhu F, Schneditz D, Levin NW. Sum of segmental bioimpedance analysis during ultrafiltration and hemodialysis reduces sensitivity to changes in body position. Kidney Int. 1999 Aug;56(2):692-9. doi: 10.1046/j.1523-1755.1999.00588.x.
Steuer RR, Germain MJ, Leypoldt JK, Cheung AK. Enhanced fluid removal guided by blood volume monitoring during chronic hemodialysis. Artif Organs. 1998 Aug;22(8):627-32. doi: 10.1046/j.1525-1594.1998.06036.x.
Lopot F, Kotyk P, Blaha J, Forejt J. Use of continuous blood volume monitoring to detect inadequately high dry weight. Int J Artif Organs. 1996 Jul;19(7):411-4.
Bogaard HJ, de Vries JP, de Vries PM. Assessment of refill and hypovolaemia by continuous surveillance of blood volume and extracellular fluid volume. Nephrol Dial Transplant. 1994;9(9):1283-7.
Leunissen KM, Kooman JP, van Kuijk W, van der Sande F, Luik AJ, van Hooff JP. Preventing haemodynamic instability in patients at risk for intra-dialytic hypotension. Nephrol Dial Transplant. 1996;11 Suppl 2:11-5. doi: 10.1093/ndt/11.supp2.11.
Kouw PM, Kooman JP, Cheriex EC, Olthof CG, de Vries PM, Leunissen KM. Assessment of postdialysis dry weight: a comparison of techniques. J Am Soc Nephrol. 1993 Jul;4(1):98-104. doi: 10.1681/ASN.V4198.
Franz M, Pohanka E, Tribl B, Woloszczuk W, Horl WH. Living on chronic hemodialysis between dryness and fluid overload. Kidney Int Suppl. 1997 Jun;59:S39-42.
Zhu F, Kuhlmann MK, Sarkar S, Kaitwatcharachai C, Khilnani R, Leonard EF, Greenwood R, Levin NW. Adjustment of dry weight in hemodialysis patients using intradialytic continuous multifrequency bioimpedance of the calf. Int J Artif Organs. 2004 Feb;27(2):104-9. doi: 10.1177/039139880402700205.
Frankel VH, McLeod KJ. Calf muscle pump stimulation as an adjunct to orthopaedic surgery. Surg Technol Int. 2005;14:297-304.
Madhavan G, Stewart JM, McLeod KJ. Effect of plantar micromechanical stimulation on cardiovascular responses to immobility. Am J Phys Med Rehabil. 2005 May;84(5):338-45. doi: 10.1097/01.phm.0000159970.81072.8b.
Madhavan G, Stewart JM, McLeod KJ. Cardiovascular systemic regulation by plantar surface stimulation. Biomed Instrum Technol. 2006 Jan-Feb;40(1):78-84. doi: 10.2345/0899-8205(2006)40[78:CSRBPS]2.0.CO;2.
Stewart JM, Karman C, Montgomery LD, McLeod KJ. Plantar vibration improves leg fluid flow in perimenopausal women. Am J Physiol Regul Integr Comp Physiol. 2005 Mar;288(3):R623-9. doi: 10.1152/ajpregu.00513.2004. Epub 2004 Oct 7.
Primary Completion
December 2014
Actual (reported)Study Completion
February 2015
Actual (reported)Last Updated
February 24, 2016
Record last verified: 2016-02
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